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Deciding which neonates require treatment for a low arterial blood pressure (BP) often is difficult. To some extent, this has been due to a lack of normative BP data, particularly among preterm neonates. However, we now have reliable data relating birthweight, gestational age, and postnatal age to BP in term and preterm neonates. Nevertheless, the management of suspected hypotension in various neonatal intensive care units differs. Although there are good studies comparing various modes of therapy, prospective trials relating long-term outcome to treatment versus no treatment at various BP values have not been performed.

Concern about the deleterious effects of hypotension is greater for preterm neonates primarily because of the relative inability to regulate cerebral blood flow in preterm neonates compared with infants who are born at term.

Clearly, the primary issue surrounding possible hypotension in preterm neonates is the concern...

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